Benchmarks in colorectal surgery: multinational study to define quality thresholds in high and low anterior resection
British journal of surgery, vol. 109, pp. 1274–1281
Abstract
BACKGROUND: Benchmark comparisons in surgery allow identification of gaps in the quality of care provided. The aim of this study was to determine quality thresholds for high (HAR) and low (LAR) anterior resections in colorectal cancer surgery by applying the concept of benchmarking. METHODS: This 5-year multinational retrospective study included patients who underwent anterior resection for cancer in 19 high-volume centres on five continents. Benchmarks were defined for 11 relevant postoperative variables at discharge, 3 months, and 6 months (for LAR). Benchmarks were calculated for two separate cohorts: patients without (ideal) and those with (non-ideal) outcome-relevant co-morbidities. Benchmark cut-offs were defined as the 75th percentile of each centre's median value. RESULTS: A total of 3903 patients who underwent HAR and 3726 who had LAR for cancer were analysed. After 3 months' follow-up, the mortality benchmark in HAR for ideal and non-ideal patients was 0.0 versus 3.0 per cent, and in LAR it was 0.0 versus 2.2 per cent. Benchmark results for anastomotic leakage were 5.0 versus 6.9 per cent for HAR, and 13.6 versus 11.8 per cent for LAR. The overall morbidity benchmark in HAR was a Comprehensive Complication Index (CCI®) score of 8.6 versus 14.7, and that for LAR was CCI® score 11.9 versus 18.3. CONCLUSION: Regular comparison of individual-surgeon or -unit outcome data against benchmark thresholds may identify gaps in care quality that can improve patient outcome.
Authors 43
-
Roxane D. Staiger corresponding
Affiliation as printed
Department of Colorectal Surgery, University Hospital Zurich , Zurich , Switzerland
-
Affiliation as printed
Department of Colorectal Surgery, University Hospital Zurich , Zurich , Switzerland
-
Affiliation as printed
Department of Surgery, Seoul National University College of Medicine , Seoul , Korea
-
University of British Columbia · St. Paul's Hospital
Affiliation as printed
Department of Surgery, University of British Columbia, St Paul’s Hospital , Vancouver, British Columbia , Canada
-
Bellvitge University Hospital · Institut d'Investigació Biomédica de Bellvitge · Universitat de Barcelona
Affiliation as printed
Bellvitge University Hospital, Department of General and Digestive Surgery, and IDIBELL, University of Barcelona , Barcelona , Spain
-
National Cancer Center Hospital East
Affiliation as printed
Department of Colorectal Surgery and Surgical Technology, National Cancer Centre Hospital East , Kashiwa, Chiba , Japan
-
Humboldt-Universität zu Berlin · Freie Universität Berlin · Charité - Universitätsmedizin Berlin
Affiliation as printed
Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin , Berlin , Germany
-
Hospital Italiano de Buenos Aires
Affiliation as printed
Section of Colorectal Surgery, Hospital Italiano de Buenos Aires and Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB) , Buenos Aires , Argentina
-
Université Paris Cité · Hôpital Beaujon
Affiliation as printed
Department of Colorectal Surgery, Beaujon Hospital and University of Paris , Clichy , France
-
Cliniques Universitaires Saint-Luc
Affiliation as printed
Department of Colorectal Surgery, Cliniques Universitaires St-Luc – UCL , Brussels , Belgium
-
Leiden University · Leiden University Medical Center
Affiliation as printed
Department of Surgery, Leiden University Medical Centre , Leiden , the Netherlands
-
National University of Singapore · National University Health System
Affiliation as printed
Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, University Surgical Cluster, National University Health System , Singapore
-
Affiliation as printed
A. C. Camargo Cancer Centre , São Paulo , Brazil
-
Affiliation as printed
Division of Colorectal Surgery, Department of Surgery, Medical College of Wisconsin , Milwaukee, WI , USA
-
Federico II University Hospital · University of Naples Federico II
Affiliation as printed
Department of General Surgery and Specialty, University Federico II of Naples , Naples , Italy
-
Affiliation as printed
Department of Colorectal Surgery, Royal Prince Alfred Hospital , Sydney, New South Wales , Australia
-
Affiliation as printed
Department of Colorectal Surgery, University Hospital Zurich , Zurich , Switzerland
-
Affiliation as printed
Department of Colorectal Surgery, University Hospital Zurich , Zurich , Switzerland
-
Bundesinstitut für Öffentliche Gesundheit · German Inflammatory Bowel Diseases Study Group
Affiliation as printed
Centre for Bowel Diseases , Brzeziny , Poland
-
Affiliation as printed
Surgery Department, Charles University and Central Military Hospital , Prague , Czech Republic
-
St. Vincent's University Hospital
Affiliation as printed
Centre for Colorectal Disease, St Vincent’s University Hospital , Dublin , Ireland
-
Affiliation as printed
Department of Surgery, Seoul National University College of Medicine , Seoul , Korea
-
University of British Columbia · St. Paul's Hospital
Affiliation as printed
Department of Surgery, University of British Columbia, St Paul’s Hospital , Vancouver, British Columbia , Canada
-
Bellvitge University Hospital · Institut d'Investigació Biomédica de Bellvitge · Universitat de Barcelona
Affiliation as printed
Bellvitge University Hospital, Department of General and Digestive Surgery, and IDIBELL, University of Barcelona , Barcelona , Spain
-
National Cancer Center Hospital East
Affiliation as printed
Department of Colorectal Surgery and Surgical Technology, National Cancer Centre Hospital East , Kashiwa, Chiba , Japan
-
Humboldt-Universität zu Berlin · Freie Universität Berlin · Charité - Universitätsmedizin Berlin
Affiliation as printed
Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin , Berlin , Germany
-
Hospital Italiano de Buenos Aires
Affiliation as printed
Section of Colorectal Surgery, Hospital Italiano de Buenos Aires and Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB) , Buenos Aires , Argentina
-
Université Paris Cité · Hôpital Beaujon
Affiliation as printed
Department of Colorectal Surgery, Beaujon Hospital and University of Paris , Clichy , France
-
Cliniques Universitaires Saint-Luc
Affiliation as printed
Department of Colorectal Surgery, Cliniques Universitaires St-Luc – UCL , Brussels , Belgium
-
Leiden University · Leiden University Medical Center
Affiliation as printed
Department of Surgery, Leiden University Medical Centre , Leiden , the Netherlands
-
National University of Singapore · National University Health System
Affiliation as printed
Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, University Surgical Cluster, National University Health System , Singapore
-
Affiliation as printed
A. C. Camargo Cancer Centre , São Paulo , Brazil
-
Affiliation as printed
Division of Colorectal Surgery, Department of Surgery, Medical College of Wisconsin , Milwaukee, WI , USA
-
Federico II University Hospital · University of Naples Federico II
Affiliation as printed
Department of General Surgery and Specialty, University Federico II of Naples , Naples , Italy
-
Affiliation as printed
Department of Colorectal Surgery, Royal Prince Alfred Hospital , Sydney, New South Wales , Australia
-
Bundesinstitut für Öffentliche Gesundheit · German Inflammatory Bowel Diseases Study Group · Medical University of Lodz
Affiliation as printed
Centre for Bowel Diseases , Brzeziny , Poland
Department of General and Colorectal Surgery, Medical University , Lodz , Poland
-
Affiliation as printed
Surgery Department, Charles University and Central Military Hospital , Prague , Czech Republic
-
St. Vincent's University Hospital
Affiliation as printed
Centre for Colorectal Disease, St Vincent’s University Hospital , Dublin , Ireland
-
Affiliation as printed
Department of Colorectal Surgery, St Mark’s Hospital , London , UK
-
Affiliation as printed
Department of Colorectal Surgery, St Mark’s Hospital , London , UK
-
Affiliation as printed
Department of Colorectal Surgery, University Hospital Zurich , Zurich , Switzerland
-
Affiliation as printed
Department of Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich , Zurich , Switzerland
-
Affiliation as printed
Department of Colorectal Surgery, University Hospital Zurich , Zurich , Switzerland
Cited by 26 stored of 26
No patents citing this paper on Lens.org (checked 2026-10-11).